SVC Syndrome caused by distant history of central line

Superior Vena Cava (SVC) occlusion causing SVC Syndrome is most commonly caused by malignancy, but there are several benign etiologies. With the increased use of central venous catheters since the 1960’s, thrombus formation around the catheter has been an increasing cause of SVC occlusion. Most commonly, SVC occlusion happens while the catheter is in place. In this particular case, the SVC Syndrome was most likely the sequelae of a temporary central line placed and removed 16 years prior to diagnosis.

Nicholas DuRocher 2016-06-03 03:15:03

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Nicholas DuRocher 2016-06-02 02:06:34

Unfortunately it is a diagnosis of exclusion. The Pt. has avoided hospitals and doctors most of his adult life, and has a very sparse medical history. That being said, he has no other pathology or insults that can account for calcification of his SVC. But there is no way to conclusively prove this short of maybe obtaining a pathological diagnosis which is not clinically warranted at this time.

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Roland Talanow 2016-06-01 13:19:17

Thank you for your nice case. However, the diagnosis is hypothesis driven. Can you prove that the cause is truly by the remotely placed catheter?

Thank you

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Nicholas DuRocher 2016-05-29 16:19:40

Once again, I submitted my post too early without all the information.

The Pt. also had been complaining of a R inguinal bulge which bothered him when he coughed. This was diagnosed as an inguinal hernia by the clinical staff, but was discovered to be a large collateral vessel.

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Nicholas DuRocher 2016-05-29 16:15:46

Sorry, first time doing this.

48yo M presented with chest pain after a long bus trip. A CT PE Protocol was performed which showed an obstructed SVC. The only explanation was a central line placed and removed 16 years prior.